Treatment Protocols for Newborns of Mothers Living with HIV

Development in HIV treatments allow individuals living with HIV to live normal, healthy lives, and for many women, that includes carrying and delivering a child. However, when a woman is living with HIV, there are risks that the virus may be vertically transmitted to the baby. Treatment protocols have been developed to minimize the risk of virus transmission to newborns.

Mother and Newborn Treatment Protocol Considerations

Treatment protocols for both the mother and newborn are largely determined by the mother’s current HIV treatment regimen. In other words, how the mother and baby are treated may be different for:

  • A woman aware of her HIV status and receiving antiviral therapy before and during pregnancy
  • A woman who becomes of aware of her HIV status while pregnant
  • A woman who has not received antiviral therapy during pregnancy

In most cases, if a mother was already receiving antiviral therapy, that treatment will continue throughout pregnancy to suppress viral loads. If HIV infection was determined late in the pregnancy, it may be too late for oral antiviral drugs, so IV drugs may be administered during delivery.

Common Newborn/Infant HIV Treatment Protocol

While there are many factors that must be considered to determine what treatment protocol to follow, for most mothers living with HIV, treatment for their newborns will involve:

  • Antiviral medications (usually zidovudine) administered by IV during birth
  • Antiviral medications given to the baby within eight hours of birth until six weeks

Mothers may be encouraged to electively deliver via Cesarean section to minimize the infant’s exposure to maternal blood. The procedure may increase the risk to the mother, and for women who have been on sustained antiviral/antiretroviral therapy and have maintained undetectable viral loads, the procedure may not present any significant reduction in vertical transmission risk. All mothers-to-be living with HIV should discuss this option with their medical team.

Infants of mothers living with HIV will be monitored and regularly tested for the virus. HIV- status will not be declared until negative test results persist for 18 months.

Because HIV in infants is often indicated by opportunistic infections (rather than positive HIV test results), newborns will be monitored and receive prophylactic treatment for Pneumoncystis carinii pneumonia. Infants are at highest risk for infection between three to six months, so treatment begins nearly immediately and typically continues throughout the first year of life.

Prenatal Education and Medical Services

If you are living with HIV and have become pregnant or want to become pregnant, please visit UNM Truman Health Services. We provide educational resources and medical care that can improve the prognosis for you and your baby.